Objective

Although previous studies have implicated the negative outcomes of sarcopenia, evidence is limited to one or a few types of cancer. The aim of this study was to evaluate the distribution and influencing factors of sarcopenia, and explore the relationship between sarcopenia and cancer prognosis in a large oncological population.

Methods

This observational cohort study included patients diagnosed with malignant cancer between May 2011 and January 2019. Hematologic and anthropometric parameters were collected prospectively. Low skeletal muscle mass and radiodensity were diagnosed using clinical indicators, according to the two prediction models. The importance of potential risk factors for sarcopenia was estimated by subtracting the predicted degrees of freedom from the partial χ² statistic. Hazard rates of death were calculated using the hazard function and Cox regression analyses.

Results

We included 13 761 patients with cancer; the prevalence of sarcopenia was 33%. The median age was 58 y and 7135 patients (52%) were men. Patients with sarcopenia had a worse nutritional status and quality of life than those without sarcopenia. Age was the most important risk factor for sarcopenia compared with body mass index or TNM stage. Additionally, patients with sarcopenia had a significantly higher and earlier peak risk for mortality. After adjusting for baseline characteristics, sarcopenia was independently associated with mortality in the research population (hazard ratio, 1.429; P < 0.001) and most cancer types.

Conclusion

Age is the most important risk factor for sarcopenia even in patients with cancer. Sarcopenia is strongly associated with a poor quality of life and reduced overall survival.

中文翻译：

---

癌症患者肌肉减少症的患病率及其与不良预后的关系：针对常见癌症的全国性调查

客观的

尽管之前的研究已经暗示了肌肉减少症的负面结果，但证据仅限于一种或几种类型的癌症。本研究的目的是评估大型肿瘤人群中肌肉减少症的分布和影响因素，并探讨肌肉减少症与癌症预后的关系。

方法

这项观察性队列研究包括 2011 年 5 月至 2019 年 1 月期间诊断出患有恶性肿瘤的患者。前瞻性收集血液学和人体测量参数。根据两个预测模型，使用临床指标诊断低骨骼肌质量和放射密度。^{通过从部分 χ 2}统计量中减去预测的自由度来估计肌肉减少症潜在危险因素的重要性。使用风险函数和 Cox 回归分析计算死亡率风险率。

结果

我们纳入了 13 761 名癌症患者；肌肉减少症的患病率为 33%。中位年龄为 58 岁，7135 名患者 (52%) 为男性。肌肉减少症患者的营养状况和生活质量比没有肌肉减少症的患者更差。与体重指数或 TNM 分期相比，年龄是肌少症最重要的危险因素。此外，肌肉减少症患者的死亡风险峰值明显更高且更早。调整基线特征后，肌肉减少症与研究人群的死亡率独立相关（风险比，1.429；P < 0.001）和大多数癌症类型。

结论

即使对于癌症患者来说，年龄也是肌少症最重要的危险因素。肌肉减少症与生活质量差和总生存率降低密切相关。